Fort Worth agency offers alternative to ‘12-step’ addiction programs that’s tailored to gay men with HIV

Tammye Nash | Senior Editor

FORT WORTH — Addiction recovery programs aren’t one size fits all.

That’s why AIDS Outreach Center recently started a new program, SMART, according to Shawna Stewart, the agency’s director of mental health services, and Leslie Guditis, the therapist heading up the new program to help the agency’s HIV-positive clients overcome addictions to alcohol and drugs.

Self Management and Recovery Training — or SMART — is intended as an alternative to “12-step” programs, Stewart said. But they stressed they aren’t suggesting SMART is “better than” 12-Step programs. “It’s just different,” Stewart said. “It’s another option for people who haven’t had success with other programs.”

Although AIDS Outreach recently had to close its Arlington offices and cut staff due to budget constraints, SMART will continue. Stewart said it’s funded with a special grant through the federal Ryan White CARE Act. The grant pays for Guditis’ part-time position to administer the program.

SMART, Guditis said, is different because “it doesn’t come from a disease model. It doesn’t label. You don’t go to a meeting and stand up and say, ‘I am an alcoholic.’”

Instead, the SMART program “teaches more about taking responsibility and looking at why one drinks or uses drugs or has any addiction, like an addiction to sex, eating. And when you know the ‘why,’ you can manage that ‘why’ instead of just saying, ‘I will never do it again.’”

“This program is about teaching an individual the tools that hopefully last a lifetime, rather than saying go to a meeting every day or every week,” Guditis said.

The 12-step programs “come from a disease model,” the therapist said. “I am not bashing any other programs. But I do think that this is a more positive way to look at addiction.”

Stewart believes this different model for recovery could be more effective for some of AIDS Outreach’s clients, many of whom are gay, because it doesn’t include reliance on a higher power. Many gays and lesbians and many people with HIV, she said, have had bad experiences with religion. So the idea of relying on a “higher power” may be less effective for people who may have felt rejected by God, she suggested.

Although she said she doesn’t necessarily believe SMART would work better for LGBT people or those with HIV in general, Guditis does think it would work better for some of them.

“I think LGBT and people with HIV sometimes already have a lot of shame, and this [SMART] is all very positive,” Guditis said. “It helps people feel like they have control over their lives. What we are trying to do is empower people.

“People with HIV feel powerless in a lot of ways, and this is really a self-esteem-building program,” she continued. “I went to a [SMART] meeting [not specific to people with HIV or LGBT people], and the people in the meeting were so proud of their ability to be in control of the choices they make. They were proud to feel like they do have a choice. I saw people’s chests almost swell with pride in being able to manage their behavior.”

Guditis also noted that despite the acronym, a person doesn’t need to be “smart” to succeed in the program. “The techniques are very simple and pretty well spelled out,” Guditis said. “This is a kind of psycho-education type program. People don’t just talk about their problems or a binge over the weekend. It’s a more positive and supportive, a mutual learning environment. There are no sponsors, no hierarchy. It’s a setting of equals with a facilitator managing the discussion. That is my job, to be the facilitator.”

Another difference from a 12-step program is that SMART doesn’t require abstinence, Stewart and Guditis said.

“Abstinence is promoted, but if someone comes to a meeting and they have been using, they are still welcome in,” Guditis said. “We work from that place to manage the behavior, and not try to make them feel shamed for using. We talk about emotions, triggers for addictive behavior. People take pride in being in control of their behaviors.”

Guditis, who recently received a doctorate in family therapy from Texas Women’s University, spent the month of June training in the SMART program. She held the first SMART session at AIDS Outreach on July 6. “We initially wanted to have three SMART groups each week, but we are starting with one, each Tuesday. We want to have at least two groups a week, though,” Guditis said. “We will add more as we see the need.”

The sessions at AIDS Outreach, she added, are only for the agency’s clients. If the program proves effective at AIDS Outreach for alcohol and drugs, it could eventually be expanded to include those fighting other addictive behaviors, too.

This article appeared in the Dallas Voice print edition July 9, 2010.